GI Inf: Perspective Flashcards
What pathogens cause NONinflammatory diarrhea?
ETC viruses parasites (except amebiasis) v. cholera others all inflammatory
When should viral diarrhea be suspected?
vomiting prominent
incubation period >14h
lasts <3 days
When clinical findings make viral diarrhea less likely?
fever
tenesmus
dysentery
What is the main syndrome caused by E. histolytica?
dysentery w paucity of fecal leukocytes
What is one risk factor for traveler’s diarrhea?
PPI therapy
What are common causes of CDAD?
amoxicillin variants most common
clinda and cephalosporins
How does CDAD present?
watery diarrhea, fever, leukocytes
What are the specifics of the toxin released by c. dif?
AB toxin
A = enterotoxin
B = cytotoxin
How can yersinia dysentery be recognized?
RLQ pain
few if any leukocytes in stool
can mimic appendicitis and cause bacteremia
What pathogens is stool routinely cultured for?
salmonella, shigella, campylobacter, yersinia
What diagnostic modalities can confirm the clinical diagnosis of diarrhea?
routine stool culture, special stool culture, stool ova and parasites, toxin assay for c. dificile, immunoassay for rotavirus
What is the workup for AIDS-related diarrhea?
H/P, CD4, routine labs
3 sets of stool for O/P, culture, and c. dif
if above fails, flex sig or colonoscopy (CMV)
if above fails, EGD
What are the five main points of management of acute infectious diarrhea?
volume repletion
antimotility agents - might be dangerous
adsorbents and antisecretory agents (pepto-bismol)
anti-microbials - may increase complication
prevention
